NPI | 1669664827 |
---|---|
Former Name | ANGELA M HAWKINSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA06822) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2762) |
363A00000X Physician Assistant (Licence: IL 085.003009) | |
Enumeration Date | 2007-08-13 |
Last Update Date | 2013-02-08 |